Claims Examiner - Auto

Sedgwick; Canada; À distance; CAD 65 000 - 75 000; Plein temps

Résumé du poste

Sedgwick Claims Management Services Ltd. is recruiting a Claims Examiner to analyze and process complex auto and commercial transportation claims from a remote Canada-based position. The role covers liability assessment, damage evaluation, and documentation of claim files.

You will manage litigation on litigated claims, coordinate with independent adjusters, and report large claims to excess carriers. Strong communication and negotiation skills are essential.

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• Secure and maintain the State adjusting licenses as required for the position.

Responsabilités

• Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly.
• Responsible for litigation process on litigated claims.
• Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims.
• Reports large claims to excess carrier(s).
• Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.
• Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage.
• Communicates claim action/processing with insured, client, and agent or broker when appropriate.
• Performs other duties as assigned.
• Supports the organization's quality program(s).
• Travels as required.

Connaissances

Auto claims knowledge

Medical terminology

Negotiation skills

Communication skills

Teamwork

Microsoft Office

Organizational skills

Claims processing

Formation

Bachelor's degree

Outils

Microsoft Office

Description du poste

## Claims Examiner - AutoApply: Canada Telecommuter: Full time: Posted Today: R79919By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.Claims Examiner - Auto**PRIMARY PURPOSE**: To analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES*** Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly.* Responsible for litigation process on litigated claims.* Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims.* Reports large claims to excess carrier(s).* Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.* Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage.* Communicates claim action/processing with insured, client, and agent or broker when appropriate. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES*** Performs other duties as assigned.* Supports the organization's quality program(s).* Travels as required. **QUALIFICATIONS** **Education & Licensing**Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Secure and maintain the State adjusting licenses as required for the position. **Experience** Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage’s, principles, and laws. **Skills & Knowledge*** In-depth knowledge of personal and commercial line auto policies, coverage’s, principles, and laws* Knowledge of medical terminology for claim evaluation and Medicare compliance* Knowledge of appropriate application for deductibles, sub-limits, SIR’s, carrier and large deductible programs.* Strong oral and written communication, including presentation skills* PC literate, including Microsoft Office products* Strong organizational skills* Strong interpersonal skills* Good negotiation skills* Ability to work in a team environment* Ability to meet or exceed Service Expectations The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.at any time.